Hard to See with Diabetes

Dr. Roger Phelps explains diabetic retinopathy and how it may be contributing to growing vision problems

/ Author:  / Reviewed by: Robert Carlson, M.D

From your head to your toes, diabetes can lead to serious complications. Even your eyes can become damaged by the disease. But don't be alarmed; you can protect your vision through regular eye exams and proper management of your diabetes.

A recent study found that rates of non-refractive visual impairment - or vision problems that can't be fixed by glasses - are on the rise. According to the researchers, these rising rates may be the result of the growing diabetes epidemic.

About 14 million Americans 12 years of age and older are visually impaired. About 11 million have vision problems due to refractive error, meaning the problems can be corrected by glasses. That still leaves millions of patients with non-refractive vision problems, which can be caused by a number of diseases, including diabetic retinopathy - or damage to the eye's retina caused by diabetes.

In this study, Fang Ko, MD, of Johns Hopkins University School of Medicine, and colleagues set out to measure rates of non-refractive visual impairment and to gain a better understanding of what may be causing these vision problems.

The researchers found that rates of non-refractive visual impairment grew by about 21 percent between 1999 and 2008.

Diabetes is one of the main causes of blindness. With that in mind, Dr. Ko and colleagues concluded that rising rates of diabetes may be to blame for the rising rates of non-refractive visual impairment.

Ask an Expert

dailyRx had the recent opportunity to interview Dr. Roger Phelps, an optometrist, diabetes educator and diabetes patient. Through our conversation, Dr. Phelps was able to answer some common questions about diabetic eye damage. In addition, he explained what the study by Dr. Ko and colleagues means for the future of eye care and diabetes care.

dailyRx: How does diabetes affect the eyes?

Dr. Phelps: Diabetes is the most common cause of vision loss in adults in the United States and can lead to full blindness if left untreated. What happens most frequently is that the blood vessels in the eyes begin to leak and impair vision. Additionally, new blood vessels can grow where they aren’t supposed to be - for example on your retina, permanently damaging vision.

dailyRx: What are the signs and symptoms of diabetes-related eye damage?

Dr. Phelps: The frightening fact is that most people have no idea that their vision is being threatened by the disease. Since diabetes and pre-diabetes can take years to develop, only an eye doctor can detect damage inside your eyes. Unfortunately, if you are to the point where you’re experiencing a change in vision, years of damage have likely already been done. At that point, the damage can possibly be stopped, but cannot be reversed.

dailyRx: How can diabetic eye damage be prevented? That is, what advice do you give or how do you encourage patients to take the necessary steps to prevent diabetic eye damage?

Dr. Phelps: The absolute most important step to protect your vision is to get annual comprehensive eye exams. By going to your eye doctor every year, he or she will be able to quickly identify any changes to the health of your eyes and can then help coordinate the necessary treatment plan to ensure any problem is addressed immediately.

dailyRx: How can diabetic eye damage be treated?

Dr. Phelps: Damage to the eyes from diabetes is often treated with lasers or injections to minimize further blood vessel leakage. However, if the problem is caught early enough, medication or lifestyle changes can help the eyes recover and avoid further damage. It is important to note that while this damage can many times be stopped from progressing, it cannot be undone.

dailyRx: What is non-refractive visual impairment?

Dr. Phelps: Refractive impairment is essentially a person’s inability to see, or see well, without glasses. Non-refractive impairments are conditions or diseases that cannot be corrected with a simple pair of glasses.

dailyRx: What causes non-refractive visual impairment?

Dr. Phelps: Diabetic retinopathy, age-related macular degeneration (eye disease that causes vision loss in the center of the field of vision), cataracts (clouding of the lens of the eye) and glaucoma (damage to the optic nerve) are examples of causes of non-refractive visual impairment. These conditions can emerge out of genetics or poor vision care. Lifestyle habits, such as diet and nutrients, also play a role.

dailyRx: How can Dr. Ko and colleagues conclude that the rising rates of non-refractive visual impairment may be due to rising rates of diabetes?

Dr. Phelps: Since diabetic retinopathy is a leading cause of blindness, an increase in cases of diabetic retinopathy would point to an increase in cases of diabetes. This is substantiated by statistics that show that diabetes is twice as prevalent as it was 20 years ago.

dailyRx: What do the findings by Dr. Ko and colleagues mean for the future of eye care and eye health?

Dr. Phelps: This study and many others in the past few years underscore the importance of integrating annual eye care into one’s healthcare regimen. As more people get diabetes, the cases of eye disease and vision loss will also increase unless people in general become more vigilant of their eye health.

dailyRx would like to thank Dr. Phelps for offering his expert knowledge on such an important topic.

About Dr. Phelps:
Dr. Roger Phelps is a VSP optometrist (http://www.facebook.com/VSPVisionCare) and a Certified Diabetes Educator who has practiced for over four decades. Dr. Phelps has Type 1 Diabetes and frequently travels the country delivering speeches and presentations on preventing diabetes-related blindness. 

Review Date: 
December 17, 2012